- The Washington Times - Friday, July 21, 2017

The White House begged senators Friday to “step up” and start debate on a plan that throws Obamacare in the dustbin, declaring the GOP is just a few votes shy of taking up the repeal-and-replace bill that passed the House in May.

“It’s time to vote, It’s time to act. It’s time to get on with a debate to repeal and replace the Affordable Care Act,” Vice President Mike Pence told supportive groups at the White House, including the U.S. Chamber of Commerce and National Taxpayers Union. “Any senator who doesn’t vote to begin the debate is essentially telling the American people that they’re fine with Obamacare. And that’s just not the truth.”

Enough Senate Republicans blocked efforts to proceed onto a replacement bill this past week, and a sufficient number then blocked efforts to take up a Plan B — the straight repeal plan that President Obama vetoed more than a year ago.

It’s unclear which path to repeal will take precedent moving forward, or if any of them can gather enough support, though the administration said President Trump’s preference is for Republicans to both repeal and replace the law.

“It’s time for them to step up and get that done,” White House Press Secretary Sarah Huckabee Sanders said.

Senate Majority Leader Mitch McConnell wants to move onto the bill Tuesday, setting the stage for an open amendment process and potential passage before Congress breaks for its August recess.

GOP leaders say the Senate must get on the underlying House bill and let the most popular ideas win out. They say holdouts should be brave enough to start debate and then withhold their votes for final passage, if that’s their stance.

But with every Democrat defending President Obama health law, the motion to even get on the bill must attract at least 50 votes from the GOP’s narrow majority, with Mr. Pence serving as tie-breaker.

“We’ve probably got I think 45 or 46 ’yes,’ now. It’s a handful of ’no’s’ right now,” Sen. Ted Cruz, Texas Republican, told Fox News. “I think they’re going to get to yes. I don’t know how you face people who elected you when you won’t even vote to take up the bill.”

Some GOP moderates want to let states take their Obamacare money and do what they want with it, while others want to hold hearings on the best way to fix Obamacare’s ailing markets, so Democrats are included.

Pro-Obamacare groups are pressuring GOP holdouts to resist repeal.

A coalition known as Save My Care released ads Friday urging Sen. Dean Heller, Nevada Republican, facing a tough re-election bid, to “take a stand” and vote against any GOP plan. The six-figure buy also targets Republican senators Shelley Moore Capito of West Virginia and Lisa Murkowski of Alaska, who’ve opposed a repeal-only bill.

The Capito ad specifically highlights the opioid crisis in her state, saying Medicaid cuts in the plan would slash treatment.

On Thursday, the CBO estimated that 22 million people fewer people would hold insurance a decade from now under the latest version of the Senate GOP replacement bill, known as the Better Care Reconciliation Act. In June, CBO analysts said an earlier version of the bill would result in the same number losing coverage, spooking GOP moderates.

Former CBO chiefs defended the federal agency against Republican attacks in a letter to congressional leaders Friday, saying its nonpartisan scorekeepers’ cannot nail every prediction about policy but frequently do a better job than less-informed analysts.

“Unfortunately, even nonpartisan and high-quality analysis cannot always generate accurate estimates. Policy changes are often complex, the economy is dynamic and defies precise prediction, and many policies are modified over time. However, such analysis does generate estimates that are more accurate, on average, than estimates or guesses by people who are not objective and not as well informed as CBO’s analysts,” they wrote.

The signers span the political spectrum and several decades, from Alice M. Rivlin, who led the CBO at its founding in 1975, to Douglas M. Elmendorf, who served during the Obama years.

The latest score of the Senate health bill did not include an amendment that Mr. Cruz proposed to let insurers sell plans that don’t comply with Obamacare’s coverage regulations.

Mr. Cruz and Sen. Mike Lee, Utah Republican, argue that including a version of the “freedom” amendment would drive down premiums for healthier consumers, though analysts say the idea would segment the marketplace, driving up costs for sicker consumers.

Republicans are using fast-track process, known as “budget reconciliation,” to bypass a filibuster of its health plans, since the Republican majority consists of 52 seats and cannot overcome the 60-vote threshold to proceed over Democratic opposition.

Yet the Senate’s referee — the parliamentarian — can scratch policy changes that aren’t related to the budget during a vetting process known in Capitol-speak as the “Byrd bath.”

The Cruz plan could be at risk, among other provisions, such as one that bars customers from using government tax credits to buy plans that cover abortion.

Pro-life groups would revolt if the language is stripped, so lawmakers would probably try to legislate around any problem.

Some conservatives say leaders should allow Mr. Pence, as president of the Senate, to override the parliamentarian while presiding over the chamber.

• Sally Persons contributed to this article.

• Tom Howell Jr. can be reached at thowell@washingtontimes.com.

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